Rabu, 13 Oktober 2010

Beating high blood pressure with food

10 tips for using diet to control blood pressure.

Fiddling with diet to control cholesterol makes perfect sense. After all, some of the cholesterol that ends up in arteries starts out in food. Changing your diet to control blood pressure doesn't seem quite so straightforward. Yet food can have a direct and sometimes dramatic effect on blood pressure.

Salt certainly plays a role. But there is far more to a blood pressure–friendly diet than minimizing salt intake. Fruits, vegetables, low-fat dairy foods, beans, nuts, whole-grain carbohydrates, and unsaturated fats also have healthful effects on blood pressure.

There isn't a single "magic" food in this list. Instead, it's the foundation for an all-around healthful eating strategy that is good for blood pressure and so much more. Rigorous trials show that eating strategies such as the Dietary Approaches to Stop Hypertension (DASH) diet, DASH variants like the OmniHeart diet, and Mediterranean-type diets lower blood pressure in people with hypertension (high blood pressure) and those headed in that direction. They also help prevent some of the feared consequences of high blood pressure.

Why bother?

Hypertension is the ultimate stealth condition. You'd never know you have it without having your blood pressure measured — or until high blood pressure begins to damage vital organs.

Half of the 65 million American adults with high blood pressure don't have it under control. That's worrisome given the insidious consequences of high blood pressure. It is the leading cause of stroke in the United States. It contributes to thousands of heart attacks. It overworks heart muscle, leading to heart failure. It damages the kidneys, erodes sight, interferes with memory, puts a damper on sexual activity, and steals years of life.

Blood pressure categories

 

Systolic

 

Diastolic

Normal (optimal)

<120

and

<80

Prehypertension

120–139

or

80–89

Hypertension

≥140

or

≥90

10 tips

Drugs that lower blood pressure tend to work well. But they don't necessarily attack the cause of the problem. And no matter how safe they are, all drugs have some unwanted or unintended side effects.

A healthful diet is an effective first-line defense for preventing high blood pressure. It is an excellent initial treatment when blood pressure creeps into the unhealthy zone, and a perfect partner for medications. Unfortunately, translating the dietary strategies tested in clinical trials into diets for daily life hasn't been easy.

Drs. Frank M. Sacks and Hanna Campos, of the Department of Nutrition at Harvard School of Public Health, have done just that. In the June 3, 2010, New England Journal of Medicine, they offer evidence-based advice about diet and blood pressure, complete with a weekly shopping list (see below):

  • Eat more poultry, fish, nuts, and legumes (beans) and less red meat.

  • Choose low-fat or nonfat milk and other dairy products instead of full-fat versions.

  • Turn to vegetables and fruits instead of sugary or salty snacks and desserts.

  • Select breads, pasta, and other carbohydrate-rich foods that are made from whole grains instead of highly refined white flour.

  • Eat fruit instead of drinking fruit juice.

  • Use unsaturated fats like olive, canola, soybean, peanut, corn, or safflower oils instead of butter, coconut oil, or palm-kernel oil.

  • Rely on fresh or frozen foods instead of canned and processed foods.

  • Choose low-sodium foods whenever possible; use herbs, spices, vinegar, and other low-sodium flavorings instead of salt.

  • Don't skip meals; try to eat one-third of your calories at breakfast.

  • If you need help, record everything that you eat day by day for a week. Have this information reviewed by a dietitian.

Weekly shopping list

As an aid for healthier eating, Drs. Frank M. Sacks and Hanna Campos recommend this weekly shopping list.

Type of food

Servings per week

Amount to buy for a week

Leafy salad greens (lettuce, spinach, etc.)

4

1–2 heads or bags

Other greens (kale, chard, etc.)

4

1–2 bunches

Broccoli, cabbage, cauliflower

3

1–2 heads

Tomatoes, carrots, peppers, avocados, eggplant, and other colorful vegetables

15

8–12 items

Celery, green beans, peas

3

½ pound

Fresh fruit (apples, pears, grapes, bananas, peaches, oranges, etc.)

20

15–20 items

Dried fruit (raisins, prunes, dates, etc.)

8

½ pound

Tomato sauce, paste, juice

4

2 jars or cans

Fruit juice

4

1 quart

Fish, shellfish

2

1 pound

Chicken, turkey

2

1 pound

Red meat (limit cold cuts, sausage, other processed meats)

1

¼ pound

Eggs

3

3 large

Dried beans

3

1 pound

Breakfast cereal (preferably whole grain)

2

1½–2 cups

Pasta, rice, grains

3

½ to 1 cup (dry)

Low-fat or skim milk

10

½ gallon

Yogurt

3

3 cups

Cheese

4

¼ pound

Nuts

10

½ pound

Olives

2

¼ to ½ pound

Baked goods (whole-grain bread, rolls, waffles, etc.)

20

1½ pounds

Popcorn, pretzels, chips

3

4 ½ ounces

Chocolate

1

7 ounces

Cooking oils

12

¾ cup

Table fat (olive oil, oil-based spread)

16

cup

Salad dressings and mayonnaise

21

½ cup

Sugars

24

½ cup

Desserts

1

½ cup

Salt

7

2tsp

Source: http://www.health.harvard.edu/newsletters/Harvard_Heart_Letter/2010/October/beating-high-blood-pressure-with-food

Information about the OmniHeart diets

The Optimal Macronutrient Intake Trial for Heart Health (OmniHeart) study compared the effects of three heart-healthy diets, all based on the Dietary Approaches to Stop Hypertension (DASH) diet — one emphasized carbohydrates, another emphasized protein, and the third emphasized unsaturated fat. Although all three lowered blood pressure and improved cholesterol and triglyceride levels, the higher-protein and higher-unsaturated-fat diets worked best.

The general plan for all three diets looked like this:

  • Eat 1-2 servings of fruit at every meal and have an extra fruit at breakfast.

  • Have 2-3 servings of vegetables at lunch and dinner.

  • Create a fruit and nut trail mix for snacks: ¼ cup dried fruit with 1 oz. unsalted nuts.

  • Each day have a serving of fat-free or low-fat milk and milk product (milk, yogurt, cheese) at two meals and occasionally at a third meal or snack.

  • Use whole grains rather than refined grains as often as possible.

  • Select lean versions of meats and remove skin from poultry.

The breakdown of calories and nutrients in the three OmniHeart diets are listed in the table below. You can also download a 7-day menu for the higher-protein diet or for the higher-unsaturated-fat diet.

Food group

Servings per day

 

Higher carbohydrate diet

Higher protein diet

Higher unsaturated fat diet

Fruit and juices (½ cup)

6.6

3.8

4.8

Vegetables (½ cup)

4.4

5.4

6.3

Grains, mostly whole grains (1 oz or ½ cup)

5.3

5.0

4.3

Milk and milk products (1 cup)

2.1

2.5

1.9

Legumes, nuts, seeds, other vegetable protein (1 oz meat-equivalents)

1.3

3.0

1.2

Beef, pork, ham (1 oz)

0.9

1.1

1.0

Poultry (1 oz)

1.6

2.6

1.8

Fish (1 oz)

1.1

1.3

1.0

Egg product substitutes
(1 oz meat-equivalents)

0.2

1.1

0.1

Desserts and sweets (tsp sugar)

4.6

2.5

1.7

Fats and oils (tsp)

6

3.5

12

Nutrient targets

Percent of daily calories

 

Higher carbohydrate diet

Higher protein diet

Higher unsaturated fat diet

Carbohydrates

58

48

48

Total fat

27

27

37

Monounsaturated fat

13

13

21

Protein

15

25

15



Source: http://www.health.harvard.edu/newsletters/Harvard_Heart_Letter/2010/October/information-about-the-omniheart-diets